JP5898274B2 - Rotating prism endoscope - Google Patents

Description

  The present invention relates to a field-of-view direction variable endoscope, and more particularly to a rigid shaft endoscope provided with a rotating prism provided at a distal end thereof.

  In the field-of-view direction variable endoscope, the user can switch the field-of-view direction of the endoscope without changing the position of the endoscope. Endoscopes with variable viewing direction are generally classified into two types: rigid and flexible. The user wants to observe the tissue beside or behind the endoscope tip, but the endoscope shaft cannot be moved easily due to anatomical constraints or limitations of other surgical instruments in the surgical field Sometimes a field-of-view variable endoscope is useful.

  A field-of-view endoscope is desirable because it provides more flexibility to the surgeon's surgical approach. For example, when a general diagnostic screening is a cystoscopy including an examination of a lesion or tumor in the bladder inner wall, the diagnostic accuracy is improved if the visual field is easily moved. When making this type of diagnosis, the ability to observe the side and the reverse direction is important because it can visually cover the entire bladder wall, including the entrance region near the bladder neck. In otolaryngology or neurosurgery, the operation is delicate and the entrance port is small, so it is desired to switch the visual field. Therefore, it is difficult to operate the endoscope without seriously damaging the patient. Side-view and back-view functions are important, but when a tumor fragment needs to be tracked during or after tumor resection, it can become the nucleus of a new tumor if it cannot be found. Laparoscopy, another surgical discipline, is forced to operate less, but when the field of view is switched, the surgeon can obtain a more desired viewing angle during surgery and enhance diagnostic capabilities. Because you can, you can receive many benefits. In order to further improve the diversity of the field of view, the field-of-view endoscope has the ability to obtain a standard field of view from a non-standard position, minimizing collisions with other tools and simplifying surgical planning. So that the surgeon can continue to maintain the desired field of view as the endoscope is moved sideways.

  A fundamental feature of a field-of-view variable endoscope is usually the elimination of blind spots for the surgeon. The blind spot movement occurs in the process of moving the device within the patient's body without being able to observe where the device is heading. That is, when it is not possible to see what is in front of the endoscope and it is necessary to advance the fixed-viewing-angle side endoscope in its length direction, or around the field boundary of the endoscope When a surgical tool has to be manipulated, a blind spot movement occurs.

  In general, a surgeon can easily operate a rigid endoscope rather than a flexible endoscope. This is because there is a fixed relationship between the endoscope tip and the surgeon's hand. When the surgeon moves his hand, the movement of the proximal end of the endoscope is transmitted directly to the distal end of the endoscope, and the surgeon sees how the end of the endoscope moves with the movement of the hand. It becomes easy to image in the head. This is not the case for flexible endoscopes where the dynamic relationship between the distal and proximal ends of the endoscope is not always clear. For this reason, the use of flexible endoscopes often requires significant training, and many surgeons opt for rigid endoscopes if the situation allows.

  Rigid endoscopes and flexible endoscopes are usually designed for different applications, and rigid endoscopes and flexible endoscopes are not compatible. Although flexible endoscopes are widely used in the medical market, a rigid endoscope with a variable visual field direction has not yet been established. Over the years, many rigid endoscopes with viewable orientation have been developed, but the traditional goal of fixed viewing angle endoscopes is to provide the surgeon with improved visual field movement. . Although this goal was realized, unfortunately the disadvantages outweighed the advantages. The priority given to the driving means sacrifices some optical channels, and the priority given to the driving means limits the field of view. Inferior to that obtained with a fixed angle endoscope. The driving means increases the complexity and cost for the design, manufacturing, and assembly operations. Increasing mechanical complexity conversely reduces robustness and makes sterilization more difficult. Furthermore, an attempt has been made to create an ergonomic and user-friendly endoscope with variable view direction. In various surgical research fields, particularly in laparoscopy, it is necessary to allow a surgeon to keep the endoscope flat throughout the patient's body in order to access a site of tissue. This operation requires an endoscope having a minimum handle that is substantially symmetrical around the main axis of the endoscope. For this reason, the gun grip type handle is not suitable for surgical use.

  The current field-of-view variable microscope (soft or rigid with a bent tip) has another major problem of missing. When the line of sight of the endoscope changes, the user faces two problems. The first problem is that it is difficult to keep track of the part being viewed with the endoscope. By using a rigid endoscope with a fixed viewing angle, the user can predict the endoscope field of view relatively easily from the position of the endoscope shaft. This is not the case when the user immediately loses sight of the spatial localization movement within the observed tissue when the viewing direction changes at regular intervals relative to the long axis of the endoscope. The second problem is that it becomes difficult to keep track of the upper part of the endoscopic image. When the image is rotated with respect to the surroundings by the visual field changing means, the user easily loses sight of the visual field direction. In particular, in a field-of-view variable endoscope equipped with an imaging device at the distal end, it is almost impossible to correct the visual field direction if it is lost.

  Considering the problem of the endoscope with a variable viewing direction, a surgeon generally uses a rigid endoscope with a fixed viewing angle. Surgeons rely heavily on the knowledge that a given endoscope has a viewing angle of 30 or 45 degrees. One reason for choosing an endoscope with multiple fixed viewing angles is because the surgeon knows how the tissue will look with a given endoscope.

  Therefore, there is a need for a variable viewing direction endoscope having a driving means that can reduce the complexity and cost of the apparatus, and also provide an apparatus that is robust and easy to sterilize. It has been demanded. Furthermore, there is a need for a drive means that can minimize the number of optical channels sacrificed by the apparatus. There is also a need for an ergonomic variable viewing direction endoscope that can improve the operability and ease of handling of the apparatus. Furthermore, there is a need for a variable viewing direction endoscope that can assist the surgeon in maintaining spatial orientation when the viewing angle is changed.

  Accordingly, an object of the present invention is to provide a rotating prism endoscope, which is arranged in the proximal direction and the far end between the proximal end and the distal end of the endoscope. Oscillate in a lateral direction (oscillate), and is provided distally to rotate the rotating prism around its prism axis by a proximal and distal movement of the control member in a proximal direction and a distal direction. A control member connected to the pivoting prism, a control surface having a variable contour shape, and moving with respect to the control surface in contact with the control surface and moving the control member in a proximal direction while contacting the control surface And an engaging member that moves back and forth in the distal direction. The engaging member may be formed on a driving member that rotates around the long axis of the endoscope. The control surface may be formed on a driving member that rotates around the long axis of the endoscope.

  Another object of the present invention is that the variable contour shape of the control surface comprises a peak corresponding to the maximum viewing angle of the rotating prism and a valley corresponding to the minimum viewing angle of the rotating prism. There is to be.

  A further object of the present invention is that the engagement member or the control surface is magnetically connected to the prism adjustment knob, and the movement of the prism adjustment knob corresponds to the engagement member or the control surface. It is to cause movement. The prism adjustment knob is provided in a radial direction above the engagement member or the control surface, and can rotate around the long axis of the endoscope.

  Another object of the present invention is to provide the endoscope with a handle, which includes the long axis of the endoscope and is provided in the vicinity of the prism adjustment knob. The prism adjustment knob can be rotated by holding the endoscope.

  It is a further object of the present invention to provide a one-to-one correspondence between the rotation of the prism adjustment knob and the change in the viewing angle of the rotation prism.

  Further, the endoscope advantageously has at least one preset viewing angle position, and when the prism adjustment knob is rotated to the preset viewing angle position, the prism adjustment knob is moved to the preset viewing angle position. Fixed to. In one embodiment, the prism adjustment knob includes an arrangement member, and the arrangement member extends along the long axis of the endoscope and includes a part of the endoscope including the long axis of the endoscope. Engaging and having a receiving member, the receiving member receives and fixes the positioning member at the current viewing angle position.

  A further object of the present invention is to provide the endoscope with a rotating prism provided at the distal end, and the rotating prism can change the viewing angle of the endoscope. It changes between the front substantially parallel to the long axis and the side forming an angle with respect to the long axis of the endoscope. When the rotating prism is matched with the front viewing angle, the rotating prism guides the optical image to the transmission optical system or the solid-state imaging device without substantially changing the direction of the optical image. When the rotating prism is matched to the side viewing angle, the rotating prism changes the direction of the optical image between the first direction and the second direction, thereby transmitting the optical image to the transmission optical system or the solid-state imaging. Reflects towards the element. In a preferred embodiment, the rotating prism is a dove prism.

  Another object of the present invention is to provide the rotating prism in a housing constituting an observation window between a front viewing angle and a side viewing angle. It is preferable that the observation window between the front viewing angle and the side viewing angle has a spherical arc shape.

  Other objects, detailed features, and effects of the present invention will become more apparent based on the following drawings and the accompanying description.

It is a perspective view of the rotation prism endoscope concerning this invention. FIG. 5 is a perspective view of the distal end of the rotating prism endoscope according to the present invention with the distal portion of the outer housing removed. FIG. 4 is a schematic diagram of a distal end for explaining a rotation prism, a transmission optical system, and a drive wire in the rotation prism endoscope according to the present invention. It is the figure which looked at the proximal end of the rotation prism endoscope concerning this invention from the side. FIG. 6 is a side view of the proximal end of the rotating prism endoscope according to the present invention with the endoscope part constituting the handle removed. FIG. 5 is a view of the proximal end of the rotating prism endoscope according to the present invention as viewed from another side in a state where an endoscope part constituting the handle is removed. FIG. 5 is a view of the proximal end of the rotating prism endoscope according to the present invention as viewed from another side in a state where an endoscope part constituting the handle is removed.

  The following detailed description is an example of the invention and is not intended to limit the principles of the invention. This description allows one skilled in the art to make and use the invention, and describes various embodiments, applications, modifications, alternatives, and uses of the invention, and the best mode of carrying out the invention at the present time. Including what is considered.

  FIG. 1 shows a variable field-of-view endoscope 100, which has a rigid shaft 115 extending between a proximal end 110 and a distal end 120. It has. The endoscope 100 has a central axis 116 surrounded by endoscope constituent members. When the distal end 120 is inserted into the body cavity, the light source adapter 113 supplies light from the proximal end 110 to the distal end 120 of the endoscope 100 so that light is emitted from the distal end to the body cavity. . The distal end 120 includes a rotating prism that rotates around the prism axis and receives an optical image of the body cavity. Optics components within the rigid shaft 115 guide the light image from the distal end 120 to the proximal end 110. In order to observe the optical image received by the rotating prism, the surgeon grasps the endoscope 100 with the grasping handle 111 having the central axis 116 and observes the inside of the body cavity through the eyepiece 112. Alternatively, a camera known to those skilled in the art can be connected to or replaced with the eyepiece 112 to project the body cavity on the video monitor.

  The pivoting prism pivots about its prism axis so that the surgeon can change the viewing angle of the endoscope without changing the spatial arrangement of the endoscope within the body cavity. While grasping the handle 111, the surgeon can use the same hand to rotate the prism adjustment knob 114 about the central axis 116, which moves the rotating prism around its prism axis. And the angle at which the rotating prism receives the optical image with respect to the central axis 116 of the endoscope 110 is changed. The rotating prism operation with one hand is facilitated by the fact that the handle 111 and the prism adjustment knob 114 are provided close to each other and both include a central axis 116. By arranging the handle 111 and the prism adjustment knob 114 around the central axis 116 of the endoscope 100, and arranging the handle 111 and the prism adjustment knob 114 in the vicinity of each other, the endoscope 100 can be viewed by the surgeon. Provides an excellent ergonomic device that facilitates the use of mirrors.

  A more detailed view of the distal end 120 of the endoscope 100 is shown in FIGS. 2A and 2B. As shown in these drawings, the dove prism 126 is rotated around its prism axis 130 by the wire 122 connected to the dove prism 126. The wire 122 extends between the proximal end 110 and the distal end 120 and is connected to the prism adjustment knob 114 in a manner that will be described in detail later. When the prism adjustment knob 114 is rotated, the dove prism 126 is rotated around its prism axis 130 by moving the wire 122 in the proximal direction and the distal direction.

  In the detailed embodiment shown in FIGS. 2A and 2B, the dove prism 126 has a viewing angle of 0 degrees (154) relative to the central axis 116 and 120 degrees (158) relative to the central axis 116. It is possible to rotate between the sides. When the dove prism 126 is positioned at 0 degree (154), the dove prism 126 linearly guides the optical image to the transmission optical system 134 via the dope prism 126 without changing the direction of the optical image. It is characterized by that. When the dope prism 126 is located on the side, the dope prism 126 bends the optical path of the optical image toward the transmission optical system 134 and guides the side view to the eyepiece 112. Alternatively, a solid-state imaging device such as a CCD imaging device or a CMOS imaging device can be integrated with the transmission optical system 134 or the transmission optical system 134. In the said embodiment, the imaging surface of a solid-state image sensor can be set | placed on a distal end, and can be arrange | positioned in the orthogonal direction with respect to the central axis of an endoscope. The imaging surface can receive image light from the dove prism via a transmission optical system or directly. The dove prism can simplify the configuration for guiding the optical image to the transmission optical system, i.e., clarify the necessity of providing a plurality of mirrors or prisms to bend the optical image direction. It is advantageous. As a result, the diameter of the distal end of the endoscope can be reduced by a simplified mechanism. Further, the dove prism 126 is advantageous because it is a single prism and can easily observe the front, side, and rear (> 90 degrees).

  In order to allow the dove prism 126 to be secured within the endoscope 100, the distal housing 138 is provided at the distal end 120 near the transmission optics 134 and defines a cavity for receiving the dove prism 126. Built-in. The distal housing 138 is characterized by a curved surface 162, and the curved surface 162 has a spherical arc shape (that is, a spherical cross-sectional shape). In addition, the projection 150 that receives the observation window (not shown) having a corresponding curved surface has a spherical arc shape. When the observation window is formed in a spherical arc shape, the optical characteristics of the endoscope are improved, and the endoscope can obtain a high-quality optical image over the entire observation range of the rotating prism 126. At least a part of the spherical arc-shaped observation window is configured to have a window length, width, and contour shape corresponding to the dimension of the protrusion 150, and the spherical arc-shaped observation window portion forms a curved surface 162. It is formed so as to be surrounded by the housing 138 portion. By providing the observation window on the protrusion 150, the curved surface 162 protects the observation window from damage.

The manner in which the prism adjustment knob 114 moves the wire 122 in the proximal and distal directions is typically accomplished by connecting the wire 122 to a control surface that swings between front and rear. That is, the control member moves in the proximal end direction and the distal end direction of the endoscope 100. While the control member is moving in the proximal and distal directions, the control member maintains its direction on the long axis of the endoscope 100 by not rotating. Furthermore, the endoscope 100 incorporates a variable surface and an engaging member. The variable surface has a contour shape that changes from the oblique side surface of the endoscope 100.
That is, a portion of the variable surface extends in the distal direction. The engaging member contacts the variable surface and slides along the variable surface. In one embodiment, the variable surface remains stationary with respect to the long axis, while the engagement member moves relative to the variable surface. In another embodiment, the engagement member remains stationary relative to the major axis while the variable surface moves relative to the engagement member. In any event, the control member moves in the proximal direction by movement of the engagement member toward the variable surface portion extending in the distal direction while the components move relative to each other. By moving the engagement member away from the variable surface portion extending in the distal direction, the control member moves in the distal direction. These members provide improved drive means for changing the viewing angle of the endoscope. These two configurations reduce the complexity of the typical drive means and allow the drive means to be adjusted so that the surgeon is misguided.

  3A-3D show a preferred embodiment for adjusting the viewing angle of the rotating prism. A control member 210 including the long axis of the endoscope 100 is provided in the handle 111. The control member 210 includes a variable surface 211 that is oriented toward the distal end of the endoscope 100. The contour shape of the variable surface 211 changes from the laterally oblique direction of the endoscope 100 so that the variable surface 211 includes a trough 212 and a top 213 extending in the distal direction. The slope transition portion 214 extends from the valley 212 to the mountain 213. Further, a drive member 220 is disposed in the handle 111 in the direction opposite to the variable surface 211, and the drive member 220 also includes the long axis of the endoscope 100 and rotates around the long axis. . The drive member 220 includes an engagement member 221, which extends from the drive member 220 in the proximal direction along the long axis and is in contact with the variable surface 211. The drive member 220 includes a prism adjustment knob 230 that also rotates about the major axis. The prism adjustment knob 230 and the drive member 220 are magnetically connected. That is, either the prism adjustment knob 230 or the drive member 220 includes a magnetic element, and when the surgeon rotates the prism adjustment knob 230, the drive member 220 rotates in the same direction. Because of this magnetic connection, the endoscope can be sealed, the knob can be located completely outside, allowing easier cleaning and sterilization.

  The proximal surface of the control surface 210 is in contact with the spring 240. The spring 240 is interposed between the control surface 210 and the spring holding member 241. When the engagement member 221 moves along the variable surface 211, the spring 240 presses the variable surface 211 against the engagement member 221 so that the engagement member 221 and the variable surface 211 are in contact with each other.

  During the operation, the surgeon rotates the prism adjustment knob 230 clockwise or counterclockwise. The drive member 220 is similarly rotated by the magnetic connection between the prism adjustment knob 230 and the drive member 220. When the driving member 220 rotates, the engaging member 221 slides along the variable surface 211. When the engaging member 221 is slid toward the peak portion 213, the control member 210 is displaced in the proximal direction. When the engaging member 221 is slid toward the valley 212, the control member 210 is pulled in the distal direction. While the drive member 220 is rotating, the control member maintains the direction with respect to the long axis.

In order to improve the skill of the surgeon who accurately adjusts the viewing angle of the rotating prism, the rotation of the adjusting knob 230 preferably corresponds to the change in the viewing angle of the rotating prism on a one-to-one basis. That is, when the prism adjustment knob 230 is rotated by 30 degrees, the viewing angle of the rotating prism changes by 30 degrees.
This can be realized by selecting an appropriate combination of the reflection angle of the rotating prism and the inclination of the inclination transition region 214. Further, the use of the mark on the endoscope 100 allows the surgeon to know the current viewing angle of the rotating prism, and further improves the skill of the surgeon to operate the rotating prism. For example, FIG. 3B shows a mechanism by which a surgeon determines whether the pivoting prism is in a standard preset position. In this embodiment, a part of the housing of the endoscope 100 is in the vicinity of the prism adjustment knob 230 and around the long axis 116, for example, 0 degree, 30 degrees, 45 degrees, 70 degrees, 90 or 120 degrees. And a plurality of sets of dimples 234 positioned at a standard endoscope viewing angle. Rod 232 is connected to prism adjustment knob 230 and extends distally beyond the housing portion with dimple 234. When the prism adjustment knob 230 is rotated to change the viewing angle of the prism, the rod 232 is rotated above the housing surface. When the rod 232 is positioned beyond the standard viewing angle, the rod is received and fixed between a pair of dimples. By using the dimple 234, the surgeon can visually or sensibly determine when the pivoting prism is positioned at a standard viewing angle. Alternatively, the dimple 234 can be replaced with a recess formed in the housing surface and the receiving rod 232. The advantage of the preset position is that the surgeon can set the viewing angle to the preset position and feel comfortable that the viewing angle of the endoscope is exactly the desired angle, eg 30 degrees. There is in being able to. As mentioned above, surgeons often rely on the knowledge that a given endoscope has a viewing angle of 30 or 45 degrees, and the surgeon knows how the tissue looks with a given endoscope. The endoscope of the present invention provides the surgeon with a simplification of one endoscope having a variable field of view and allows the surgeon to see the viewing angle set on the endoscope.

  The present invention has been described with reference to the presently preferred embodiment so that an understanding of the present invention can be obtained. However, various alternative designs and alternative constructions are possible within the scope of the present invention. Therefore, it should be understood that the scope of the present invention is not limited to the above-described embodiment, but can be widely applied to multi-directional observation apparatuses. Accordingly, all modifications, variations, equivalents, and implementations that fall within the scope of the appended claims should be considered within the scope of the invention.

DESCRIPTION OF SYMBOLS 100 ... Endoscope 122 ... Control member 126 ... Prism 210 ... Control surface 221 ... Engagement member

Claims (15)

A control member that is connected to a pivoting prism provided at the distal end and moves back and forth between the proximal end and the distal end of the endoscope in the proximal direction and the distal direction. The rotating prism is rotated around its prism axis by movement, and the control member maintains the direction of the control member with respect to the long axis of the endoscope during the back-and-forth movement of the control member. Members,
A control surface having a variable contour shape;
An engagement member that contacts the control surface, moves relative to the control surface, and moves the control member back and forth in a proximal direction and a distal direction while contacting the control surface;
A driving member, wherein the engaging member is formed on the driving member, and the driving member rotates around a long axis of the endoscope;
With
The rotating prism endoscope characterized in that the drive member is magnetically connected to a prism adjustment knob, and the movement of the prism adjustment knob causes a movement corresponding to the drive member . A control member that is connected to a pivoting prism provided at the distal end and moves back and forth between the proximal end and the distal end of the endoscope in the proximal direction and the distal direction. The rotating prism is rotated around its prism axis by movement, and the control member maintains the direction of the control member with respect to the long axis of the endoscope during the back-and-forth movement of the control member. Members,
  A control surface having a variable contour shape;
  An engagement member that contacts the control surface, moves relative to the control surface, and moves the control member back and forth in a proximal direction and a distal direction while contacting the control surface;
  A drive member, wherein the control surface is formed on the drive member, and the drive member rotates about a long axis of the endoscope;
  With
  The rotating prism endoscope characterized in that the drive member is magnetically connected to a prism adjustment knob, and the movement of the prism adjustment knob causes a movement corresponding to the drive member. The variable contour control surface and mountains corresponding to the maximum viewing angle of the rotating prism, the claims and valleys corresponding to the minimum viewing angle of the rotation prism, characterized in that it comprises a to 1 or 2. The rotating prism endoscope according to 2. The prism adjustment knob, the engaging member or is provided in a radial direction at above the control surface, according to claim 1 or 2, wherein the pivoting about the longitudinal axis of the endoscope Rotating prism endoscope. In addition, with a handle,
The rotation according to claim 1 or 2 , wherein the handle includes the long axis of the endoscope in the vicinity of the prism adjustment knob so that the prism adjustment knob can be turned by holding the endoscope with one hand. Prism endoscope. Furthermore, engaging the control surface, the control surface, characterized in that it comprises a spring mechanism for pressing so that contact with the engaging member according to claim 1 or 2 rotating prism endoscope according. Further, a prism adjustment knob is provided, and the rotation of the prism adjustment knob causes a rotation corresponding to the engaging member or the control surface, and the rotation of the knob changes the viewing angle of the rotation prism. When one-to claim 1 or 2 endoscope rotation prism wherein correspond to 1. The endoscope has at least one preset viewing angle position;
8. The rotating prism endoscope according to claim 7 , wherein when the prism adjustment knob is rotated to the preset viewing angle position, the prism adjustment knob is fixed to the preset viewing angle position. The prism adjustment knob includes an arrangement member,
The disposing member extends along the long axis of the endoscope, includes the long axis of the endoscope, and includes a receiving member at a current viewing angle position. Together
9. The rotating prism endoscope according to claim 8 , wherein the receiving member receives and fixes the arrangement member at the viewing angle position. The rotation prism endoscope according to claim 1 or 2 , wherein the rotation of the rotation prism changes a viewing angle of the endoscope between a front side and a side. When the rotating prism is made to coincide with the front viewing angle, the rotating prism guides the optical image to the transmission optical system or the solid-state imaging device without substantially changing the direction of the optical image. The rotating prism endoscope according to claim 10 . When the rotating prism is matched with the side viewing angle, the rotating prism changes the direction of the optical image between the first direction and the second direction, thereby transmitting the optical image to the transmission optical system or the solid-state imaging. The rotating prism endoscope according to claim 11, which reflects toward the element. The rotating prism claim 1 or 2 endoscope rotation prism, wherein it is a Dove prism. The rotating prism claim 1 or 2 endoscope rotation prism wherein that provided in the housing which constitutes the observation window between the front viewing angle and the side view angle. The rotating prism endoscope according to claim 14 , wherein an observation window portion between the front viewing angle and the side viewing angle is formed in a spherical arc shape.

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